Gail Williams was 15 when her mother died of a heart attack. “The world seemed like it got dimmer, a shade darker than it was,” said Williams, now 60, of New Haven. The death of Shirley Mae Burgess, Williams’ mother, at age 41 was a shock and a tragedy for her family. But it also is a story of how economic and social determinants of health shape lives. Even though deaths from heart disease have been falling, it is still the No. 1 killer for both men and women, reports the Centers for Disease Control and Prevention (CDC).
On a sunny, cool day as fall gave way to winter, a team of biologists and technicians dragged white cloths through the underbrush at Lord Creek Farm in Lyme. They were looking for blacklegged ticks, which carry Lyme disease and four other deadly illnesses. As ticks attached to the cloth, the team counted them and put them in jars for further study at their lab at the Connecticut Agricultural Experiment Station in New Haven. Japanese barberry bushes grew thickly beneath the trees at this private horse farm that for years has cooperated with Lyme disease researchers. As the group dragged cloths, they noticed ticks on each other’s pant legs and coats, and began to pick them off.
For Oliver Racco, it’s a part of his daily routine: eating a few peanut M&Ms.
It may seem like a treat to some kids, but for Oliver – and a relatively small but growing number of children – it’s an important way he and his family manage his peanut allergy. Racco, 7, who lives in West Hartford, eats the M&Ms as a daily “maintenance dose,” having recently completed an allergy desensitization process at the New England Food Allergy Treatment Center in West Hartford. The process is intended to protect people with severe allergies in the case of accidental ingestion. “Since we’ve gone through the treatment, it has taken away a lot of that worry,” said Racco’s mother, Jessica. She takes some comfort in knowing her son will be all right if he accidentally eats or is exposed to peanuts, she said.
It was a 70-degree day in January 2014, and Cristin Buckley was at her daughter’s basketball game with her husband and twin sons. The boys were planning to head to Target to buy baseball cards after the game, but before they could leave, 7-year-old Ben said he was having difficulty breathing and needed a nebulizer treatment. Ben’s dad took him home. “My husband called me and said, ‘Have you ever done a nebulizer treatment and have it not work?’ and I said, ‘No,’ and at that point he realized something was wrong,” Buckley said. Forty minutes after they left the basketball game, Ben was unconscious in their driveway.
The death rate from heart disease plummeted nationally over several decades for all racial and ethnic groups, but the rate of decline has slowed slightly and African Americans and low-income individuals are still at a higher risk of developing the disease and dying from it, according to a report from the National Center for Health Statistics. The report isn’t surprising to Dr. Edward Schuster, medical director, Stamford Health Cardiac Rehabilitation Program. “In the United States, there’s a lot of talk about income disparity, which is a political hotcake,” Schuster said. “But what we are seeing is a life expectancy disparity. According to a recent Journal of American Medical Association, if you’re a man in the top 1 percent of income, you can expect to live 13 years longer than someone in the 1 percent at the bottom.”
Heart disease is largely preventable by maintaining a balanced diet, a healthy weight and moderate exercise, with only 20 percent of cases involving genetics, said Dr. David L. Katz, who heads the Yale-Griffin Prevention Research Center, which works with communities to develop programs to control chronic diseases. But significant groups in lower income and urban areas don’t—or can’t—act on the message, Katz said.
In 2018, Dean and Paula Palozej found their son, Spencer, on the floor of his home in Manchester. Spencer was one day shy of his 30th birthday and he was found dead of a fentanyl overdose. Spencer, who worked as a landscaper, started taking oxycodone for pain after two surgeries in his early 20s. A friend told his father that he took a fentanyl pill thinking it was oxycodone. Palozej unloaded on the pharmaceutical industry, which is blamed by many for the explosion in prescription opioid use and abuse nationwide over the past two decades. “I’m disgusted with what they did—the greed they had,” he said.
Slowly—but perhaps surely—the country is beginning to address maternal mortality, both through legislation and through initiatives on the part of health care providers. This is critical. We have lost countless women to pregnancy and childbirth, and the majority of those deaths didn’t have to happen. This holds true especially for mothers of color. Black and American Indian/Alaska Native women are about three times as likely to die from pregnancy as white women, according to a study released earlier this month by the Centers for Disease Control and Prevention.
Betty Williams says giving up crack cocaine was easier than her ongoing struggle to quit cigarettes. “A cigarette is a friend,” said Williams, who lives with schizophrenia and chronic obstructive pulmonary disease. People with mental illness account for 44% of the cigarette purchases in the United States, and they are less likely to quit than other smokers. High smoking rates among people with mental illness contribute to poorer physical health and shorter lifespans, generally 13 to 30 years shorter than the population as a whole. About 37% of men and 30% of women with mental illness smoke.
The United States’ maternal mortality rate is abysmal, and women of color are particularly vulnerable. No amount of fame or fortune can run interference when it comes to mothers dying or at-risk during pregnancy, childbirth, or early motherhood. And that holds especially true for African American women. At 26.4 per 100,000 live births, the U.S. has the worst rate of maternal death in the developed world—by several times over. Even more disquieting, the U.S. rate rose by 136 percent between 1990 and 2013.
Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.